Are Fat Injections Safe for Breasts?

Oct. 22, 2008 -- Reshaping the breasts by injecting a woman's own fat works well for "touch-ups" after breast reconstruction, but is not yet proven effective for breast augmentation, according to plastic surgeons slated to present an update at the annual meeting of the American Society of Plastic Surgeons (ASPS) in Chicago.

"For breast reconstruction, there are some good data to support the safety and efficacy of fat injections, but for cosmetic use, it's a whole new ball game," says William P. Adams Jr., MD, a Dallas plastic surgeon and associate clinical professor of plastic surgery at the University of Texas Southwestern Medical Center, Dallas. He is among the doctors scheduled to discuss the technique at the Oct. 31-Nov. 5 meeting.

But no studies as yet prove the effectiveness and safety of fat injections for breast augmentation, Adams says.

However, such studies may soon be under way. Two clinical trials are now seeking women to help study fat injections (also called fat grafts) for breast enlargement.

And some experts seem to be warming to the idea of fat-enhanced breasts. At the meeting, a task force assigned by the ASPS to study fat injections plans to issue its conclusions. Although the task force stops short of making recommendations about fat injections, it suggests they "may be considered" for reconstruction and augmentation, says Karol A. Gutowski, MD, head of the division of plastic surgery at North Shore University Health System in Chicago and the task force chair.

In 2007, The American Society of Aesthetic Plastic Surgery and the American Society of Plastic Surgeons issued a joint statement of caution about fat injections for the breast, noting that they can be effective in enhancing breast appearance after reconstruction or to soften the appearance of implants in place, but not recommending fat injections for augmentation, citing a lack of data and the fear of hindering breast cancer detection.

Fat Injections for the Breast: What's Known?

Fat injections used to improve the contour of the breast after reconstruction typically involve small, limited areas, Adams says. Injections after reconstruction is "much more accepted" by physicians, he says, and many have done it for years.

Fat injections given to enhance the breast appearance after lumpectomy and radiation can help tissue damaged by radiation, says Sydney Coleman, MD, a New York City plastic surgeon who performs that technique and will discuss it at the meeting. The injections, he tells WebMD, can promote the growth of a blood supply in the breast area that received radiation and aid in reversing the effects of radiation damage.

Fat Injections: Task Force Findings

Among the task force conclusions, reached after its members reviewed 110 published studies and other data:

• Fat grafts may be considered for use in the breast for augmentation and reconstruction, as well as other sites (such as hands and face), but the techniques are not standardized and may vary from doctor to doctor.
• No specific recommendations about fat grafts for the breast can be made because of a lack of strong data.
• Reported complications (such as tissue death) suggest the technique has associated risks.
• No reports about increased risk of malignancy associated with fat grafts could be found.
• Fat injections may interfere with breast physical exams, but available data suggest they may not interfere with mammograms.
• Clinical studies are needed to look at safety and effectiveness of fat injections, as well as such factors as how long the fat will last.

The ASPS is expected to review the conclusions and decide whether to amend its 2007 statement, Gutowski says.